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General NPI Number Information
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NPI Number | 1407305261
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Entity Type | Individual
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Provider Name | MICHAEL BALDWIN D.D.S
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Gender | Male
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Dates
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Enumeration Date | 09/21/2016
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Last Update Date | 01/16/2025
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Provider Practice Location Address
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Address Line | 8012 112TH STREET CT E #320
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City | PUYALLUP
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State | WA
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Zip | 98373-7856
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Country | US
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Telephone | 253-848-2331
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Fax |
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Provider Business Mailing Address
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Address Line | 4664 67TH AVENUE CT W
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City | UNIVERSITY PLACE
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State | WA
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Zip | 98466-5612
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Country | US
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Telephone | 253-272-4759
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 60581145
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License Number State | WA
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